Clinical-alimentary tractRandomized controlled trial of biofeedback for fecal incontinence☆
Section snippets
Materials and methods
The study was set in a specialist colorectal hospital that acts as a secondary and tertiary referral center. Biofeedback is the therapy of first choice for patients who do not have major anal sphincter and perineal body disruption (these patients are offered the option of surgery). The biofeedback service is nurse-led, in the context of a multidisciplinary unit. Patients normally have been examined previously by anorectal physiologic studies and anal ultrasonography before referral for
Patient demographics
Figure 1 gives a flow chart of recruitment. A total of 103 eligible patients were not recruited because they refused randomization (59), could not commit to regular attendance (27), or were unwilling to complete the documentation (17 patients).
A total of 171 patients were recruited into the study (Table 2). There were 12 men and 159 women, with a mean age of 56 years (range, 26–85 years). They had experienced fecal incontinence for a median of 4 years (range, 2 months to 59 years). Of the 159
Discussion
This was an evaluation of different elements of conservative bowel care. Unexpectedly, the hypothesis that biofeedback would enhance the therapeutic effect compared with standard care with advice was not upheld. Sixty percent of patients with fecal incontinence entering the study reported that undergoing this treatment had improved their symptoms. However, unexpectedly, group 4, who had the most intensive input, rated the least degree of improvement and there was little difference between the
Acknowledgements
The authors thank Paul Bassett for assistance with the statistical analysis.
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Supported by Action Research for 3 years of the study (to S.C.). Action Research was not involved in the study design or the decision to publish.
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C.N., J.W.-B., S.R., and M.A.K. designed the study; C.N. and S.C. recruited and treated all the patients and input the data; all authors contributed to the analysis of the study and writing the article.